5 Steps to prevent Heart Disease

Wednesday, June 4, 2014

Why do guidelines insist on telling us what is healthy food when there is a sea change in data?

This blog is my response to Dr. Seth Baum’s blog at Policing food

Until we know which genome should eat which diet, I think Dr. Baum’s quote should be at the beginning of every diet guideline.

” In short I’m fairly certain we are all quite different, and consequently do better with different diets.” Dr. Baum

Instead the lifestyle guidelines bury this uncertainty in this statement:
“It also recognized that RCTs examining the effects on hard outcomes (myocardial infarction, stroke, HF, and CVD related death)are difficult if not impossible for a number of reasons (e.g., long-term adherence to dietary changes).”

The history of McGovern guidelines is very educational at:
Most interesting is this statement in the report above:
“The Departments made relatively few changes from the first edition,
but this second edition was issued with much less debate from either industry or the scientific community.
The 1985 Dietary Guidelines were widely accepted and were used as the framework for consumer nutrition education messages. They also were used as a guide for healthy diets by scientific, consumer, and industry groups.”
McGoverns guidelines were very controversial when they came out in 1977. What happened in 1985 that there was little controversy?
Documentaries such as
1- FED UP 2014 and
2-The Men Who Made Us Fat 2012
put forth some theories.

This Atlantic article explains that McGovern had poor data about the eating habits of early Americans who did not have heart attacks.

I am disappointed to see the latest 2013  Lifestyle guidelines  miss these important articles:

Unfortunately when Chief Scientist, Dr. Rose Marie Robertson,  of guidelines uses the term “LDL levels” instead of the guidelines suggested metric of non-HDL cholesterol we can see the problem.

High fat diets raise HDL-C.
Subtract HDL-C from Total Cholesterol and you have a better number than the LDL-C most old trials used.

Dr. Rose Marie Robertson writes: “The link between saturated and trans fat intake and LDL cholesterol levels is irrefutable, as is the link between LDL levels and coronary artery disease”

This very strong statement is too simple.
Trans fat acids are bad but grouping all fatty acids in one group is wrong as Micha article demonstrates:
“Compared with carbohydrate, the TC:HDL-C ratio is
1- non-significantly affected by consumption of myristic or palmitic acid,
2-is non-significantly decreased by stearic acid, and
3-is significantly decreased by lauric acid.”

“LDL levels” is an inexact term and
the new ACA/AHA guidelines directs us to use
non-HDL cholesterol levels as a better predictor of risk.

I believe LDL particle numbers are even better and most the literature of the past does not take non-HDL cholesterol or LDL particle numbers into account.

This is a very critical point as high fat diets raise HDL-C and thus the non-HDL cholesterol number is better than the LDL-C number.
Another reference from Lipid journal article states:
“ Among individuals who are insulin resistant, a low-fat, high-carbohydrate diet typically has an adverse effect on lipid profiles
(in addition to decreasing HDL-C,
it also increases triglyceride and LDL particle concentrations).

Thus Dr. Robertson”s statement:
“The link between saturated and trans fat intake and LDL cholesterol levels is irrefutable”.

This statement demonstrates that such certainty can not be used when imprecise and antiquated lipid terms are used.

I will end with Dr. Seth Baum’s final paragraph:
“I will emphasize one point however, and of this I am sure. No one knows what diet is best for all mankind. And until such a discovery is made, creating a food police force is probably not a good idea at all.” Dr. Baum

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